Dermatological treatment methods for treating a range of abnormalities in both the epidermis and the dermis of the human body are well known in the art. Such abnormalities can be e.g. birthmarks, port-wine stains, spider veins, varicose veins (varices) or other.
Varicose veins are dilated (expanded) distended veins that lie just under the epidermis of the skin. This condition occurs in about 15% of the population, and is seen most commonly in women who have been pregnant, but it is known to occur as early as by the age of 14-15 years.
The medical term for varicose veins is varices or venous insufficiency. The key function of the venous system is to transport deoxygenated blood from the various organs and parts of the body back to the heart. In normal functioning veins, valves located within the veins prevent the venous blood from returning back down to the leg. When these valves no longer function correctly the vein is termed ‘incompetent’ and venous blood collects in the veins, which causes them to dilate.
The result is visible outpouching varices or varicose veins that cause pain, swelling and discomfort in the lower limbs as well as long term effects such as reduced venous circulation leading to premature aging of the skin. These are indications of a malfunction in the venous system and should be investigated in order to initiate possible treatment.
The most commonly applied treatment for treating small and relatively uncomplicated varices is simple compression therapy. By compression therapy the patient is instructed to wear compression/elastic stockings or bandages for shorter or longer periods of time, until the varices are reduced or wholly treated due to increased blood circulation in the tissue. In addition to this, the patient is also typically instructed to keep the relevant limbs in a raised position when resting, in order to ease the backflow of deoxygenated blood.
In particular in relation to varicose veins, use of laser light irradiation applied to the skin of a living human is a widespread and broadly recognized treatment method, albeit such a method is regarded possible only for the treatment of smaller sized veins having a cross-section diameter in the range of 0-5 mm.
U.S. Pat. No. 6,027,495 to Miller relates to a method and apparatus for dermatological treatment used for removing vascular and pigmented lesions from the skin of a living human. The method is carried out by using a modified high power diode laser system under carefully controlled conditions. From this document, one is taught that such a treatment by laser light irradiation yields the best results on varicose veins (vessels) in the range of 0.1-3.0 mm (cf. column 11, line 7-10).
A description of state of the art non-invasive laser treatment of varices may be found in “Effective Treatment of Deep and Large Vessels with VascuLight™”, PhotoDerm® Application Notes, Volume 1, Number 6, ESC Medical Systems Ltd, 1998 (www.aesthetic.lumenis.com/pdf/treatment_of_deep.pdf), or in Moraga et al., Clinical Application Notes Vol. 8 No. 1, ESC Medical Systems, 1999 (www.aesthetic.lumenis.com/pdf/european_multicenter.pdf).
Treatment of larger sized varicose veins, i.e. having a cross-section diameter above 5-8 mm, typically relies on invasive methods. Such invasive methods can comprise of e.g. removal by surgery such as avulsion phlebectomy (removing the whole or part of the vein) which is also known as ‘stripping’, sclerotherapy (injecting an agent that obliterates the vein) or laser ablation such as endoveneous laser therapy (EVLT).
EVLT treatment involves destruction of the venous tissues by means of heat. Laser energy from a diode laser is delivered inside a vein by using an optical fiber inserted in the vein through an small incision. The laser energy closes the vein from the inside as the laser fiber is pulled through a small cannula drawn through the vein. When the diode laser is triggered, it deposits thermal energy in the blood and the venous tissues, thereby causing irreversible venous tissue damage in the irradiated area. The laser is fired repeatedly as the laser fiber is carefully and stepwise drawn through the vein until it is treated. Although a hole may turn up in the vessel wall where the laser beam makes contact with it, permanent ablation of the vein happens due to the thermal injury to the entire circumference of the vessel.
The disadvantage of the existing methods is the use of surgical methods which require an incision with instruments.